Provider Demographics
NPI:1295228138
Name:DRAPER, HEATHER GRACE
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:GRACE
Last Name:DRAPER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1505 JOHNSON FERRY RD STE 175
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30062-9109
Mailing Address - Country:US
Mailing Address - Phone:770-415-4815
Mailing Address - Fax:
Practice Address - Street 1:1505 JOHNSON FERRY RD STE 175
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30062-9109
Practice Address - Country:US
Practice Address - Phone:770-415-4815
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-13
Last Update Date:2022-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPT0134102251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic